Abstract
We report on a 78-year-old female patient, who presented to the emergency department with nausea and vomiting. Endoscopy of the upper gastrointestinal tract revealed gastric erosions and duodenal ulcers. The patient had iron deficiency anemia. Following treatment with a proton pump inhibitor (PPI) the patient developed fever, signs of inflammation and oliguric renal failure. In the urine-dipstick there was minimal hematuria and leukocyturia. Urinary protein-differentiation revealed tubular proteinuria with excretion of α1-microglobulin. Renal biopsy showed interstitial nephritis with infiltration of eosinophilic granulocytes. After stopping treatment with PPI and commencing glucocorticoid therapy, the patient recovered fully from renal failure. Allergic interstitial nephritis following PPI treatment is an important differential diagnosis of renal failure of unknown cause and has a good prognosis when promptly diagnosed and treated.
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